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Hepatobiliary surgery

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https://www.readbyqxmd.com/read/28624053/radiologic-evaluation-of-vasculobiliary-anatomy-in-the-umbilical-fissure
#1
Gu-Wei Ji, Fei-Peng Zhu, Ke Wang, Yong-Xiang Xia, Chen-Yu Jiao, Zi-Cheng Shao, Xiang-Cheng Li
BACKGROUND: Preoperative evaluation of vasculobiliary anatomy in the umbilical fissure (U-point) is pivotal for perihilar cholangiocarcinoma (PCCA) applied to right-sided hepatectomy. The purpose of our study was to review the vasculobiliary anatomy in the U-point using three-dimensional (3D) reconstruction technique, to investigate the diagnostic ability of 2D scans to evaluate anatomic variations, and to discuss its surgical implications. METHODS: A retrospective study of 159 patients with Bismuth type I, II, and IIIa PCCA, who received surgery at our institution from November 2012 to September 2016, was conducted...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28609799/hemostatic-complications-in-hepatobiliary-surgery
#2
Sarah Bos, William Bernal, Robert Porte, Ton Lisman
No abstract text is available yet for this article.
June 13, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28600711/what-s-in-a-name-tensions-between-formal-and-informal-communities-of-practice-among-regional-subspecialty-cancer-surgeons
#3
Simon C Kitto, Rachel E Grant, Jennifer Peller, Carol-Anne Moulton, Steven Gallinger
In 2007 the Cancer Care Ontario Hepatobiliary-Pancreatic (HPB) Community of Practice was formed during the wake of provincial regionalization of HPB services in Ontario, Canada. Despite being conceptualized within the literature as an educational intervention, communities of practice (CoP) are increasingly being adopted in healthcare as quality improvement initiatives. A qualitative case study approach using in-depth interviews and document analysis was employed to gain insight into the perceptions and attitudes of the HPB surgeons in the CoP...
June 9, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28595819/risk-factors-and-prediction-model-for-inpatient-surgical-site-infection-after-major-abdominal-surgery
#4
Aslam Ejaz, Carl Schmidt, Fabian M Johnston, Steve M Frank, Timothy M Pawlik
BACKGROUND: Surgical site infections (SSIs) are a common source of postoperative morbidity and a marker of surgical quality. The ability to predict the incidence of SSIs is limited and most models have poor predictive value. We sought to identify risk factors associated with SSIs and develop a prediction model for SSIs after major abdominal surgery. METHODS: A total of 1744 patients undergoing pancreatic, hepatobiliary, and colorectal resections between January 1, 2010 and August 31, 2013 at Johns Hopkins Hospital were identified...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28593266/wireless-monitoring-program-of-patient-centered-outcomes-and-recovery-before-and-after-major-abdominal-cancer-surgery
#5
Virginia Sun, Sinziana Dumitra, Nora Ruel, Byrne Lee, Laleh Melstrom, Kurt Melstrom, Yanghee Woo, Stephen Sentovich, Gagandeep Singh, Yuman Fong
Importance: A combined subjective and objective wireless monitoring program of patient-centered outcomes can be carried out in patients before and after major abdominal cancer surgery. Objective: To conduct a proof-of-concept pilot study of a wireless, patient-centered outcomes monitoring program before and after major abdominal cancer surgery. Design, Setting, and Participants: In this proof-of-concept pilot study, patients wore wristband pedometers and completed online patient-reported outcome surveys (symptoms and quality of life) 3 to 7 days before surgery, during hospitalization, and up to 2 weeks after discharge...
June 7, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28589237/choledochal-malformation-in-children-lessons-learned-from-a-dutch-national-study
#6
Maria H A van den Eijnden, Ruben H J de Kleine, Ivo de Blaauw, Paul G J M Peeters, Bart P G Koot, Matthijs W N Oomen, Cornelius E J Sloots, W G van Gemert, David C van der Zee, L W E van Heurn, Henkjan J Verkade, Jim C H Wilde, Jan B F Hulscher
INTRODUCTION: A choledochal malformation (CM) is a rare entity, especially in the Western world. We aimed to determine the incidence of CM in the Netherlands and the outcome of surgery for CM in childhood. METHODS: All pediatric patients who underwent a surgical procedure for type I-IV CM between 1989 and 2014 were entered into the Netherlands Study group on choledochal cyst/malformation. Patients with type V CM were excluded from the present analysis. Symptoms, surgical details, short-term (<30 days) and long-term (>30 days) complications were studied retrospectively...
June 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28583725/evolution-of-laparoscopic-surgery-in-a-high-volume-hepatobiliary-unit-150-consecutive-pure-laparoscopic-hepatectomies
#7
Santiago López-Ben, Alejandro Ranea, M Teresa Albiol, Laia Falgueras, Ernesto Castro, Margarida Casellas, Antoni Codina-Barreras, Joan Figueras
INTRODUCTION: Compared to other surgical areas, laparoscopic liver resection (LLR) has not been widely implemented and currently less than 20% of hepatectomies are performed laparoscopically worldwide. The aim of our study was to evaluate the feasibility, and the ratio of implementation of LLR in our department. METHODS: We analyzed a prospectively maintained database of 749 liver resections performed during the last 10-year period in a single centre. RESULTS: A total of 150 (20%) consecutive pure LLR were performed between 2005 and 2015...
May 2017: Cirugía Española
https://www.readbyqxmd.com/read/28567451/robotic-assisted-right-hepatectomy-via-anterior-approach-for-intrahepatic-cholangiocarcinoma
#8
Sanjay Goja, Manoj K Singh, Rohan Jagat Chaudhary, Arvinder S Soin
Major hepatic resection, especially right hepatectomy, has been successfully performed by specialized hepatobiliary centers using the robotic platform with low morbidity, conversion rates and outcomes comparable to laparoscopic and open surgery. The authors report a case of robotic-assisted right hepatectomy done for intrahepatic cholangiocarcinoma using anterior approach, after right portal vein embolisation for future liver remnant volume enhancement.
May 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28562348/actual-over-10-year-survival-after-liver-resection-for-patients-with-intrahepatic-cholangiocarcinoma
#9
Anfeng Si, Jun Li, Hongjun Xiang, Shichao Zhang, Shilei Bai, Pinghua Yang, Xiaofeng Zhang, Yong Xia, Kui Wang, Zhenlin Yan, Wan Yee Lau, Lehua Shi, Feng Shen
Partial hepatectomy is a potentially curative therapy for intrahepatic cholangiocarcinoma (ICC). Unfortunately, the overall surgical prognosis remains dismal and the actual 10-year survival has not been reported. This study aimed to document 10-year actual survival rates, identify the prognostic factors associated with 10-year survival rate, and analyze the characteristics of patients who survived ≥ 10 years. Among 251 patients who underwent curative liver resection for ICC between 2003 and 2006 at the Eastern Hepatobiliary Surgery Hospital, 21 patients (8...
May 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28554491/does-the-emergency-surgery-score-accurately-predict-outcomes-in-emergent-laparotomies
#10
Thomas Peponis, Jordan D Bohnen, Naveen F Sangji, Anirudh R Nandan, Kelsey Han, Jarone Lee, D Dante Yeh, Marc A de Moya, George C Velmahos, David C Chang, Haytham M A Kaafarani
BACKGROUND: The emergency surgery score is a mortality-risk calculator for emergency general operation patients. We sought to examine whether the emergency surgery score predicts 30-day morbidity and mortality in a high-risk group of patients undergoing emergent laparotomy. METHODS: Using the 2011-2012 American College of Surgeons National Surgical Quality Improvement Program database, we identified all patients who underwent emergent laparotomy using (1) the American College of Surgeons National Surgical Quality Improvement Program definition of "emergent," and (2) all Current Procedural Terminology codes denoting a laparotomy, excluding aortic aneurysm rupture...
May 26, 2017: Surgery
https://www.readbyqxmd.com/read/28546718/brachial-plexus-injury-after-right-hepatectomy
#11
Garima Daga, Prashant Balwant Kerkar
Iatrogenic nerve palsies due to faulty positioning on the operating table are commonly seen over the elbow and popliteal fossa. However, injury to the brachial plexus (BP) is rarely encountered and is a recently reported phenomenon due to the increasing number of complex surgeries including hepatobiliary surgical procedures. Brachial plexus injury (BPI) needs to be recognized as a potential complication of prolonged abdominal surgery. The present case report highlights the potential for BPI and its early recognition, management, and prevention in complex prolonged abdominal surgical procedures...
June 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28527946/the-microbiome-and-hepatobiliary-pancreatic-cancers
#12
Kosuke Mima, Shigeki Nakagawa, Hiroshi Sawayama, Takatsugu Ishimoto, Katsunori Imai, Masaaki Iwatsuki, Daisuke Hashimoto, Yoshifumi Baba, Yo-Ichi Yamashita, Naoya Yoshida, Akira Chikamoto, Hideo Baba
The human intestinal microbiome encompasses at least 100 trillion microorganisms that can influence host immunity and disease conditions, including cancer. Hepatobiliary and pancreatic cancers have been associated with poor prognosis owing to their high level of tumor invasiveness, distant metastasis, and resistance to conventional treatment options, such as chemotherapy. Accumulating evidence from animal models suggests that specific microbes and microbial dysbiosis can potentiate hepatobiliary-pancreatic tumor development by damaging DNA, activating oncogenic signaling pathways, and producing tumor-promoting metabolites...
May 17, 2017: Cancer Letters
https://www.readbyqxmd.com/read/28523565/blood-brain-barrier-permeability-is-exacerbated-in-experimental-model-of-hepatic-encephalopathy-via-mmp-9-activation-and-downregulation-of-tight-junction-proteins
#13
Saurabh Dhanda, Rajat Sandhir
The present study was designed to investigate the mechanisms involved in blood-brain barrier (BBB) permeability in bile duct ligation (BDL) model of chronic hepatic encephalopathy (HE). Four weeks after BDL surgery, a significant increase was observed in serum bilirubin levels. Masson trichrome staining revealed severe hepatic fibrosis in the BDL rats. (99m)Tc-mebrofenin retention was increased in the liver of BDL rats suggesting impaired hepatobiliary transport. An increase in permeability to sodium fluorescein, Evans blue, and fluorescein isothiocyanate (FITC)-dextran along with increase in water and electrolyte content was observed in brain regions of BDL rats suggesting disrupted BBB...
May 18, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28508279/the-coexistence-of-both-replaced-proper-hepatic-and-gastroduodenal-arteries-due-to-the-common-hepatic-artery-absence
#14
Konstantinos Natsis, Maria Piagkou, Nikolaos Lazaridis, Georgios Koimtzis, Stylianos Apostolidis
Anatomical variants of the celiac trunk (CT) branches and especially these of hepatic arteries (HAs) are among the most common variants of the arterial tree. The knowledge of the wide variability in hepatic arterial supply is of paramount importance in hepatobiliary, pancreatic, gastric, and esophageal surgery, as well as in liver transplantations. The purpose of this case report is to describe a rare variant discovered during abdominal dissection of a 74-year-old male cadaver of Greek origin, in which the common hepatic artery was absent and its branches, the proper hepatic artery (PHA) and the gastroduodenal artery (GDA) had an aberrant and separate origin...
May 15, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28505585/giant-hepatocellular-carcinoma-with-bone-metastasis-in-a-young-adult-emerged-from-pigmented-adenoma-with-beta-catenin-activation-a-case-report
#15
Sebastian Lünse, Paula Döring, Claus-Dieter Heidecke, Lars Ivo Partecke
INTRODUCTION: Hepatocellular carcinomas (HCC) that are very large in size are a very rare finding in young adult. The malignant transformation of a pigmented hepatocellular adenoma (HCA) with beta-Catenin activation is a possible cause for appearance of HCC. PRESENTATION OF CASE: We present the case of a 33-year-old male with a huge HCC with bone metastasis, emerged from pigmented HCA with beta-Catenin activation. As a two-stage surgical procedure, a left hepatectomy followed by a partial rib resection was performed...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28498235/hospital-minimally-invasive-surgery-utilization-for-gastrointestinal-cancer
#16
Meredith C Mason, Hop S Tran Cao, Samir S Awad, Farhood Farjah, George J Chang, Nader N Massarweh
OBJECTIVE: The aim of the study was to evaluate the impact of receiving care at high minimally invasive surgery (MIS)-utilizing hospitals BACKGROUND:: MIS techniques are used across surgical specialties. The extent of MIS utilization for gastrointestinal (GI) cancer resection and impact of receiving care at high utilizing hospitals is unclear. METHODS: This is a retrospective cohort study of 137,581 surgically resected esophageal, gastric, pancreatic, hepatobiliary, colon, and rectal cancer patients within the National Cancer Data Base (2010-2013)...
May 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28491882/portal-vein-thrombosis-in-the-setting-of-newly-diagnosed-cushing-s-syndrome
#17
Alexandria D McDow, Anju Gurung, Rama Poola, Carmel Fratianni, Marc Garfinkel, Michael G Jakoby
The hallmark manifestations of Cushing's syndrome (CS) are well known, but hypercoagulability is perhaps least recognized. Patients with CS are at increased risk of both spontaneous and postoperative thromboembolism, with the significant majority of events occurring in the lower extremity and pulmonary venous circulations. We present a case of portal vein thrombosis (PVT) occurring in the setting of newly diagnosed CS due to a left adrenal adenoma. Factor VIII activity was approximately 2.5-fold elevated, a known mechanism by which hypercortisolemia predisposes to venous thrombosis...
April 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28486007/concomitant-laparoscopic-perisplenic-artery-ligation-facilitates-surgery-for-hepatobiliary-disease-coexisting-with-portal-hypertension
#18
Youlong Wang, Fei Chen, Yajuan Chu, Xiaofang Tan, Jingwang Tan, Wenbin Ji
BACKGROUND: Although liver cirrhosis with portal hypertension (PH) contributes significantly to morbidity and mortality in abdominal surgery, many authors still consider this disease as an indication for surgery. In many reports, however, numerous treatment modalities focus on hypersplenism secondary to PH, irrespective of splenomegaly and PH. The proven benefits of laparoscopy seem especially applicable to patients with this complex disease. This study evaluates the safety and efficacy of laparoscopic perisplenic artery ligation (SAL) in patients with hepatobiliary disease and PH...
May 9, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28484186/index-of-convexity-a-novel-method-for-assessing-liver-functional-reserve-using-technetium-99m-galactosyl-human-serum-albumin-liver-scintigraphy
#19
Takafumi Sato, Junichi Arita, Yosuke Inoue, Rintaro Koga, Yu Takahashi, Akio Saiura
Preoperative evaluation of liver functional reserve is important in hepatobiliary surgery. Although the indocyanine green retention rate at 15 minutes (ICG-R15) is the gold standard for this purpose, a new method without technical complexity would be preferable. We assessed the usefulness of the previously established index of convexity (IOC). In total, 159 consecutive patients who underwent both technetium-99m-galactosyl human serum albumin ((99m)Tc-GSA) scintigraphy and the ICG-R15 were included. Correlation coefficients between indices from (99m)Tc-GSA scintigraphy and blood examinations including ICG-R15 were evaluated, and a conversion formula from the IOC to the ICG-R15 was established...
May 8, 2017: Bioscience Trends
https://www.readbyqxmd.com/read/28483680/preoperative-gadoxetic-acid-enhanced-mri-for-predicting-microvascular-invasion-in-patients-with-single-hepatocellular-carcinoma
#20
Sunyoung Lee, Seong Hyun Kim, Ji Eun Lee, Dong Hyun Sinn, Cheol Keun Park
BACKGROUND & AIMS: This study aimed to identify preoperative magnetic resonance (MR) imaging biomarkers for predicting microvascular invasion (MVI), to determine their diagnostic performance and to evaluate whether they are associated with early recurrence after surgery for single hepatocellular carcinoma (HCC). METHODS: The study included 197 patients with surgically resected HCC (≤5cm) who underwent preoperative gadoxetic acid-enhanced MR imaging. Significant MR imaging findings for predicting MVI were identified by univariate and multivariate analyses...
May 6, 2017: Journal of Hepatology
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